Adderall: the whole story

Oct. 26, 2011 9:01 am

For years now studies have shown a significant number of college students illegally using ADHD medication, often for the purpose of improving academic performance. This trend has sparked a debate about the ethics of non-medical uses of these psychostimulants, with some academic institutions regarding the abuse as academic dishonesty.

In light of this trend, Duke University has enacted a new policy prohibiting the non-medical use of these prescription medications for any academic purposes. However, administrators’ inability to enforce the policy raises questions as to the practicality of waging war against prescription drug abuse.

At Duke

Students at Duke University received an e-mail Sept. 2nd stating policy changes including:

The unauthorized use of prescription medication to enhance academic performance has been added to the definition of Cheating.

In the past, the use of such drugs without a prescription was only a violation under the University’s drug policy.

Stephen Bryan, the associate dean of students and director of the Office of Student Conduct, said the effort to crack down on prescription drug abuse, particularly Adderall, has been in the works for several years, and has been mainly motivated by the students.

Bryan said he understood the difficulty of enforcing such a policy, and said that is was mainly a symbolic gesture to show that the University considers such drug use to be dishonest academic conduct.

“We certainly don’t plan to drug test every student before an exam,” he said. “The hope is that students will see that the University has taken a stance, see that this [drug use] is considered cheating and will think twice before doing it.”

However, Helen Gilles, a junior at Duke University, says that students are not going to respond to such a crackdown.

“I don’t think this policy will change anything,” said Gilles. “The people who are taking these [ADHD] medications are already disregarding the drug policy. What does breaking one more policy matter?”

Gilles said that most of the people she knows who abuse ADHD medications get it from friends who have a prescription.

Non-medical use of ADHD medications also violates UNC’s drug policy. But Randy Young, spokesman for UNC Campus Police said to his knowledge there has never been an arrest for possession of Adderall or other ADHD medications on campus.

“Adderall is different because it is much easier to hide in residence halls and on campus,” Young said. “It’s not obvious when someone has taken it and it doesn’t give off a conspicuous odor like marijuana. That makes it much harder to enforce.”

The ease of access to the drug through legal prescriptions and difficulty enforcing policies are aggravating factors that aren’t helping to slow the popularity of the drug on college campuses.

Adderall abuse in college

“The non-medical use of prescription stimulants among U.S. college students is now at its highest level in 15 years,” said Sean Esteban McCabe, a research associate professor at the University of Michigan who specializes in prescription drug abuse.

Currently, amphetamines such as Adderall are approved for medical use by the FDA to treat Attention Deficit/Hyperactivity Disorder and narcolepsy.

This national trend of students abusing the drug holds true locally as well: a 2008 web-based survey of students at UNC-Greensboro and at Duke showed that 10 percent were taking stimulants for non-medical use.

Of those ten percent, 90 percent said they perceived their drug use to be beneficial, despite more than 70 percent reporting adverse reactions such as headaches, difficulty sleeping and irritability.

This study and others like it show that students at universities with higher admissions standards are more likely to abuse stimulants. These studies have also shown that students abusing ADHD medication are more likely than their peers to be white, belong to a fraternity or sorority, have lower GPAs or engage in other risky behaviors.

What the research says

Research has shown that one of the primary reasons that college students abuse Adderall is to improve their academic performance. This prevalent view of Adderall as a “performance-enhancing” drug has created a debate as to whether it constitutes academic dishonesty.

But experts say ADHD medications are not the answer for overworked college students, and that they don’t necessarily improve academic performance. Evidence by researchers has shown no cognitive improvements among stimulant users compared non-stimulant users.

A recent set of articles in the September issue of Psychological Bulletin looked at this very question. Elizabeth Smith from the Department of Psychology and Martha Farah of the Center for Neuroscience & Society at the University of Pennsylvania looked at 45 published papers and studied existing data to determine how illegal stimulants are obtained and if they can actually make people smarter.

They found that most individuals using drugs for non-medical purposes acquire them from peers or friends with a valid prescription. Research revealed that more than 50 percent of college students with a prescription for a stimulant had been offered money for their medication.

The researchers also examined the impact of ADHD medication on an individual’s ability to perform different cognitive tasks.

Here are the highlights of their conclusions about the actual cognitive effects of nonmedical use of ADHD medications:

  • No effect on control: Many of the studies found that Adderall doesn’t generally give users a greater sense of self control. For instance, ADHD medications do not make people more likely to forgo immediate smaller reward in order to take the larger reward.
  • Little or no effect on working memory: About half of the studies Smith and Farah reviewed suggest that these medications have no effect on working memory either, while the other half show small effects in which the medications improve performance. Additionally, the small effects were mainly evident in subjects that had low cognitive performance to start with, showing that the drug is more deficit-correcting than “performance-enhancing”.
  • Improves rote learning ability, not the ability to comprehend complex content: The evidence reviewed does suggest that when people are given rote learning tasks (a task in which people must memorize items on a list), their performance is improved by ADHD stimulants. However, the studies only found a correlation with rote memory tasks, not complex learning, which is more likely to appear on college exams.

Alternatives to Adderall

Medical experts note that stimulants will not transform the average healthy student into an academic prodigy, and that they are other options for students looking for an academic boost. Jude Carr, a physicians assistant at Carolina Family Practice said,

Students should never take ADHD medication without a prescription. Usually students are attempting to use these drugs to fix their study habits. There are much smarter and safer way to do that such as by teaming up with a classmate to avoid procrastination or using resources on campus to improve time management skills.

Carr also said that if students have persistent difficulty maintaining focus, they could have an attention disorder such as ADD and should see a mental health professional who can conduct a proper evaluation.